Abstract: A leadless intra-cardiac medical device (LIMD) is configured to be implanted entirely within a heart of a patient. The LIMD comprises a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart.

Abstract: Methods, systems, and apparatus for signal detection are described. In one example, a detection assembly includes a signal detector. The signal detector is configured to receive a sensor signal having a peak magnitude and a first frequency and generate an output signal having a magnitude proportional to the peak magnitude of the sensor signal and having a second frequency less than the first frequency of the sensor signal.

Abstract: A renal denervation system includes a renal denervation catheter and a flow determining system. The renal denervation catheter includes a plurality of ablation members positioned at a distal end portion thereof. The renal denervation catheter is insertable into a renal artery. The flow determining system includes a processor and first and second flow determining members spaced apart on the renal denervation catheter. The processor is configured to determine a change in blood flow through the renal artery resulting from a renal denervation procedure using the renal denervation catheter in response to input from the first and second flow determining members.

Abstract: Methods, systems, and apparatus for signal detection are described. In one example, a detection assembly includes a signal detector. The signal detector is configured to receive a sensor signal having a peak magnitude and a first frequency and generate an output signal having a magnitude proportional to the peak magnitude of the sensor signal and having a second frequency less than the first frequency of the sensor signal.

Abstract: Techniques are provided for controlling spinal cord stimulation (SCS) or other forms of neurostimulation. Far-field cardiac electrical signals are sensed using a lead of the SCS device and neurostimulation is selectively delivering using a set of adjustable SCS control parameters. Parameters representative of cardiac rhythm are derived from the far-field cardiac electrical signals. The parameters representative of cardiac rhythm are correlated with SCS control parameters to thereby map neurostimulation control settings to cardiac rhythm parameters. The delivery of further neurostimulation is then controlled based on the mapping of neurostimulation control settings to cardiac rhythm parameters to, for example, address any cardiovascular disorders detected based on the far-field cardiac signals. In this manner, a closed loop control system is provided to automatically adjust SCS control parameters to respond to changes in cardiac rhythm such as changes associated with ischemia, arrhythmia or heart failure.

Abstract: Techniques are provided for controlling and delivering spinal cord stimulation (SCS) or other forms of neurostimulation. In one example, neurostimulation pulses are generated wherein successive pulses alternate in polarity so that a pair of electrodes alternate as cathodes. Each pulse has a cathodic amplitude sufficient to achieve cathodic capture of tissues adjacent the particular electrode used as the cathode for the pulse. The neurostimulation pulses are delivered to patient tissues using the electrodes to alternatingly capture tissues adjacent opposing electrodes via cathodic capture to achieve a distributed virtual stimulation cathode. Various pulse energy savings techniques are also set forth that exploit the distributed virtual stimulation cathode.

Abstract: An implantable lead assembly includes an elongated body, a bobbin, and a conductor. The elongated body includes a distal end having an electrode and a proximal end having a header connector portion for coupling the elongated body with an implantable medical device. The bobbin is disposed in the elongated body. The conductor is disposed in the elongated body and is electrically coupled with the header connector portion and the electrode. The conductor is wound around the bobbin to form first and second inductive coils that are axially separated from each other by an inter-coil gap formed from the bobbin. The first and second inductive coils have different self resonant frequencies.

Abstract: Leadless neurostimulation (NS) device including a device body and electrodes positioned along an active side of the device body. The electrodes form a multi-electrode array that is configured to interface with nervous tissue of a patient and supply electrical pulses to the nervous tissue. The NS device also includes an electronic sub-system that is coupled to the device body. The electronic sub-system includes switching circuitry, a power source, and an inductive coil that is operably coupled to the power source. The inductive coil is configured to receive electrical power through inductive coupling with an external coil. The device body, including the inductive coil coupled thereto, is sized and shaped to be disposed within an epidural space of a patient.

Abstract: A leadless intra-cardiac medical device (LIMD) is configured to be implanted entirely within a heart of a patient. The LIMD comprises a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart.

Abstract: An assembly is provided for introducing a device within a heart of a patient. The assembly is comprised of a sheath having at least one internal passage. An intra-cardiac implantable medical device (IIMD) is retained within the at least one internal passage, wherein the IIMD is configured to be discharged from a distal end of the sheath. The IIMD has a housing with a first active fixation member configured to anchor the IIMD at a first implant location within a local chamber of the heart.

Abstract: Techniques are provided for use with an implantable medical device for detecting and assessing heart failure and for controlling cardiac resynchronization therapy (CRT) based on impedance signals obtained using hybrid impedance configurations. The hybrid configurations exploit right atrial (RA)-based impedance measurement vectors and/or left ventricular (LV)-based impedance measurement vectors. In one example, current is injected between the device case and a ring electrode in the right ventricle (RV) or RA. RA-based impedance values are measured along vectors between the device case and an RA electrode. LV-based impedance values are measured along vectors between the device case and one or more electrodes of the LV. Heart failure and other cardiac conditions are detected and tracked using the measured impedance values. CRT delay parameters are also optimized based impedance.

Abstract: Tachyarrhythmia is treated by applying anti-tachycardia pacing through at least one multi-site electrode set located on, in or around the heart. The electrode set is arranged and located such that an electrical activation pattern having a wave-front between substantially flat and concave is generated through a reentrant circuit associated with the tachyarrhythmia. The electrode set may be one of a plurality of predefined, multi-site electrode sets located on, in or around the atria. Alternatively, the electrode set may be formed using at least two selectable electrodes located on, in or around the atria.

Abstract: Systems and methods are provided for detecting the orientation and/or movement of a patient having an implantable cardiac stimulation device and evaluating whether a change in the patient's cardiac activity can be at least in part due to a change in the patient's orientation. In one particular embodiment, signals from an orientation sensor and/or a pressure sensor are evaluated to determine static positional orientation of the patient and determine based on the static orientation whether the patient's cardiac activity is abnormal.

Abstract: An exemplary method includes detecting a change in state of a cardiac valve, detecting elongation of the left ventricle substantially along its major axis, determining a time difference between the change in state of the cardiac valve and the elongation of the left ventricle and, based at least in part on the time difference, deciding whether a diastolic abnormality exists. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A leadless implantable medical device (LIMD) comprises a housing configured to be implanted entirely within a single local ventricular chamber of the heart near a local apex region. A base on the housing is configured to be secured to tissue of interest, while a distal electrode is provided on the base and extends outward such that, when the device is implanted in the local chamber, the distal electrode is configured to engage the distal apex region at a distal activation site within the conduction network of the adjacent ventricular chamber.

Abstract: A leadless intra-cardiac medical device (LIMD) configured to be implanted entirely within a heart of a patient includes a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart.

Abstract: A leadless intra-cardiac medical device comprises an integrated L-C resonant circuit pressure sensor. In some embodiments, the pressure sensor comprises a passive sensor that measures pressure in response to an externally generated excitation signal. In some embodiments, the pressure sensor comprises an active sensor that measures pressure in response to an internally generated excitation signal.

Abstract: An implantable therapy lead employs electrical conductors configured to enhance the abrasion resistance of the lead. Specifically, conductors are configured to create a surface contact area with walls of a wall lumen of a tubular body that is greater than would otherwise be possible with traditional conductors that have a circular transverse cross-section. As a result, the abrasion pressure of the conductors against the lumen walls is decreased for the conductors disclosed herein as compared to that of traditional conductors.

Abstract: An implantable therapy lead employs electrical conductors configured to enhance the abrasion resistance of the lead. Specifically, conductors are configured to create a surface contact area with walls of a wall lumen of a tubular body that is greater than would otherwise be possible with traditional conductors that have a circular transverse cross-section. As a result, the abrasion pressure of the conductors against the lumen walls is decreased for the conductors disclosed herein as compared to that of traditional conductors.

Abstract: Techniques are provided for use with an implantable cardiac rhythm management (CRMD) system equipped to deliver neurostimulation to acupuncture sites within anterior regions of the neck, thorax or abdomen of the patient. Parameters associated with the health of the patient are detected, such as parameters indicative of arrhythmia, heart failure and hypertension.